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We utilize a difference-in-difference design to examine the effect of adopting a statewide promise program on the enrollment of community college students across socio-economic status. Limited by a small sample size for treated units, we find inferential evidence that the adoption of a state-wide, last-dollar promise program for community colleges with no merit-based or need-based criteria raised the enrollment of in-state first-time-in-college, full-time students in their first year of college from families that earned between $0 and $75,000 in adjusted gross income. Effect sizes were largest for students from the lowest SES group ($0 to $30,000) approximately 168 additional students enrolled per 2-year institution per year following Tennessee Promise program adoption. Findings controlled for year-to-year variations in unemployment and state price parities. We discuss benefits and concerns regarding scholarships such as the Tennessee Promise that increase enrollment for lower-income students but do not affect the amount of financial aid included in their award packages in practice.

The COVID-19 pandemic has significantly impacted traditional design education, forcing educators to adopt digital classrooms for architectural design instruction, which has led to various challenges and suboptimal student performance. This research explores effective online design teaching methods, particularly across different design modules (IVI), using a synthesis and literature review methodology. It investigates three domains: pandemic teaching challenges, traditional design education, and suitable pandemic teaching methods. The study triangulates teaching during the pandemic, conventional techniques, and elements from content focus (CF) and support open learning (SL) methods to create a hybrid pedagogy. The proposed blended approach combines traditional design education with virtual instruction, offering guidelines for educators to structure academic activities and integrate effective online teaching strategies. The findings provide valuable insights for design instructors and educational institutions adapting to digital classrooms during the pandemic and beyond.

The present study aimed to investigate the relationship between foreign higher education and corruption in 14 home countries in the MENA region and 13 host countries from 2007 to 2021. Panel-estimated generalized least squares, robust least squares MM estimation, dynamic panel data estimation, and one-step difference generalized method of moments was used to overcome heterogeneity and endogeneity issues and increase robustness. The study adopted the positive grease-the-wheels theory of corruption and the greed or need (GONE) theory in which the need for corruption develops into greed for corruption, revealing a significant positive relationship between foreign higher education and corruption in the MENA countries. Meanwhile, the sand-in-the-wheel theory of corruption and anti-corruption mechanisms that encourage less greed per the GONE theory revealed a significant negative relationship between foreign higher education and corruption in origin countries after students returned to their home countries. The study findings support the idea that foreign knowledge is a blessing for MENA countries. Furthermore, there was a significant positive relationship between foreign higher education and corruption in the host countries because students adapted to the host country's environment. The main conclusion was that governments should encourage students to study abroad in countries with less corruption, supporting the main hypothesis, which posited that ethics and values are adopted abroad and transferred to home countries. Furthermore, constitutional reform and economic development should be adopted to implement the anti-corruption system and control public spending on education.

This article reports on a systematic review of the evidence concerning the impact of citizenship education, specifically focusing on the effect of different teaching activities on a range of active citizenship outcomes. It provides a narrative synthesis of 109 articles in peer reviewed journals, representing a wide range of methodological approaches. The review was undertaken for a teacher audience and the research team identified four themes with practical implications. First, we discuss the significance of school ethos and distinguish between distinctive aspects of ethos in the literature including relationships between students and teachers, values and behaviours. Second, we explore some of the characteristics of successful projects, including detailed consideration of the type of projects selected for action by young people, the role of teachers, and the duration of projects. This discussion suggests that, whilst full project cycles (involving students identifying and researching areas for action and devising, implementing and reviewing action plans) are valuable, there is also evidence to suggest that short, partial projects may be easier to implement and still secure comparable benefits. Third, we consider the evidence about whether and how citizenship education can have some compensatory effect, closing the civic gap between different groups of young people. In the fourth theme we consider the wide range of teaching strategies which have been demonstrated to have some success in practice.

The COVID-19 pandemic significantly impacted educational systems worldwide, leading to the closure of schools and universities. As a result, schools and universities have been forced to modify the way teaching and learning occurs. Specifically, universities had to adopt alternate learning platforms to provide instructions to learners remotely. This study explores the effects of COVID-19 on learning experience among university students in Bangladesh. Exploring students' perceptions and behavioral responses to learning identifies pedagogical obstacles and novel approaches to address the challenges. Following IRB approval, study data was drawn from 60 students by conducting ten focus groups at six public and private universities in Bangladesh. The findings of our study include five major themes: (1) "they were behind for almost two years;" (2) "the internet issue was a big problem;" (3) "financially, it impacted a lot;" (4) "I felt anxious, depressed, and hopeless;" and (5) "problems like headaches and back pain." Findings of the study address the need to prioritize need-based support and increase capacities and related skills to provide education remotely in Bangladesh. Findings can also guide educators and university administrators in responding effectively to support students.

We incorporated trauma-informed principles into the design of a synchronous, online Religion and Politics course and then evaluated impacts on student learning through qualitative methods. Using a novel approach, students self-evaluated their learning throughout the course in weekly reflections. Using content analysis and directed coding techniques, we analyzed students' reflection assessments for themes of trauma-informed principles: safety, trustworthiness, choice, collaboration, and empowerment. We found that students co-developed a sense of safety by engaging in respectful peer dialogue; established trustworthiness through self-disclosure of personal beliefs; collaborated with peers to develop a deeper understanding of course content; and acquired transferable skills through choice in assessments. In addition, students experienced empowerment by recognizing their growth in four primary areas: (1) their personal beliefs and perspectives; (2) their understanding of the course material; (3) their learning; and (4) their ability to use academic tools. Our findings extend and support existing research on the efficacy of trauma-informed practices; furthermore, our research suggests that incorporating trauma-informed principles into course design can support students in their learning as well as bolster their capacity to succeed in other areas inside and outside of the classroom (e.g., engaging in difficult conversations, seeking out support, using transferable skills in other contexts, applying course content to their own lives). Finally, our case study presents innovative approaches for assessing how students engage with trauma-informed course design.

Background: Acute malnutrition is a serious public health problem reaching to epidemic proportions in certain regions of the world. It has been reported that children with severe malnutrition have weakened immunity and are prone to developmental delays, with a higher mortality risk from common childhood illnesses such as diarrhea, pneumonia and malaria. Objective: To determine the frequency and associated factors of severe acute malnutrition in children aged 6-59 months at District Headquarter Hospital, Qambar Shahdadkot, Sindh. Methods: A cross-sectional study was conducted from November 2021 to February 2023 among children aged 6-59 months at District Headquarter Hospital, District Qamber Shahdadkot, Sindh, Pakistan. Data were collected by means of interviews using the study questionnaire. Height was measured using a height board (Stadio Meter), weight was measured using SECA digital weighting scale while mid upper arm circumference was measured using MUAC tape. Data were analyzed by SPSS version 20. Crude and adjusted odd ratios with 95% confidence interval were computed using binary logistic regression to determine the association of socio-demographic characteristics with the nutritional status of children. Results: The study results showed that the mean age of study children was 26.58±14.54 months, 101 (50.5%) of them were less than 2 years old, 109 (54.5%) were male, 149 (74.5%) were exclusively breastfed for 6 months, only 19 (9.5%) of them started weaning between the age of 4 to 6 months and 147 (73.5%) were completely immunized. Moreover, 26 (13.0%) of them had severe acute malnutrition. On the multivariable model, only child age was found to be significantly associated with the nutritional status of children (aOR: 4.07, 95% CI 1.14-14.48, p=0.030). Conclusion: Among the study sample, 13% of children had severe acute malnutrition. Moreover, among the socio-demographic characteristics studied, only the age of child was found to be significantly associated with the nutritional status of a child.

Abstract Chronic obstructive pulmonary disease (COPD) is a common, costly, and morbid condition. Pulmonary rehabilitation, close monitoring, and early intervention during acute exacerbations of symptoms represent a comprehensive approach to improve outcomes, but the optimal means of delivering these services is uncertain. Logistical, financial, and social barriers to providing healthcare through face-to-face encounters, paired with recent developments in technology, have stimulated interest in exploring alternative models of care. The Healthy at Home study seeks to determine the feasibility of a multimodal, digitally enhanced intervention provided to participants with COPD longitudinally over 6 months. This paper details the recruitment, methods, and analysis plan for the study, which is recruiting 100 participants in its pilot phase. Participants were provided with several integrated services including a smartwatch to track physiological data, a study app to track symptoms and study instruments, access to a mobile integrated health program for acute clinical needs, and a virtual comprehensive pulmonary support service. Participants shared physiologic, demographic, and symptom reports, electronic health records, and claims data with the study team, facilitating a better understanding of their symptoms and potential care needs longitudinally. The Healthy at Home study seeks to develop a comprehensive digital phenotype of COPD by tracking and responding to multiple indices of disease behavior and facilitating early and nuanced responses to changes in participants’ health status. This study is registered at Clinicaltrials.gov (NCT06000696).

Abstract Objectives Trauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury. Methods We will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant’s socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes. Discussion The trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes.

Abstract Background and aim Contamination from increased anthropogenic activities poses a threat to human health as well as the ecosystem. To develop a nanotechnological approach to improve aqua fisheries, we synthesized magnetic hematite nanoparticle-based gel and evaluated its efficacy in a cadmium-polluted closed system to decontaminate water and improve tilapia fish health. Methods Green iron oxide nanoparticles were biosynthesized by the metabolite of bacillus subtilis and incorporated into polyvinyl alcohol to construct a hydrogel by cryogelation. Key findings The cryogel had interconnected macropores with diameters widely ranging between 20 and 200 μm and could be free-floating in water. When applied in cadmium-polluted tilapia culture, this nanogel reduced turbidity and ammonia in the aquarium, adsorbed cadmium from the water with a larger quantity on the gel’s outer surface than in its center., and reduced cadmium concentration in tilapia’s liver, gills, and muscles. Application of this nano-based cryogel reduced the toxic effects of cadmium on tilapia fish. It maintained hepatic and renal cell nuclear integrity as determined by comet assay. This nano-treatment also reversed the cadmium-induced elevations of plasma lipids, glucose, stress marker cortisol, the hepatic enzymes AST and ALT, and the kidney function marker urea, and improved the lymphocytopenia and other hematological functions in tilapia fish intoxicated by cadmium.

Abstract Despite recognized need and reasonable demand, health systems and rehabilitation communities keep working in silos, independently with minimal recognition to the issues of those who require rehabilitation services. Consolidated effort by health systems and rehabilitation parties, recognizing the value, power and promise of each other, is a need of the hour to address this growing issue of public health importance. In this paper, the importance and the need for integration of rehabilitation into health system is emphasized. The efforts being made to integrate rehabilitation into health systems and the potential challenges in integration of these efforts were discussed. Finally, the strategies and benefits of integrating rehabilitation in health systems worldwide is proposed. Health policy and systems research (HPSR) brings a number of assets that may assist in addressing the obstacles discussed above to universal coverage of rehabilitation. It seeks to understand and improve how societies organize themselves to achieve collective health goals; considers links between health systems and social determinants of health; and how different actors interact in policy and implementation processes. This multidisciplinary lens is essential for evidence and learning that might overcome the obstacles to the provision of rehabilitation services, including integration into health systems. Health systems around the world can no longer afford to ignore rehabilitation needs of their populations and the World Health Assembly (WHA) resolution marked a global call to this effect. Therefore, national governments and global health community must invest in setting a priority research agenda and promote the integration of rehabilitation into health systems. The context-specific, need-based and policy-relevant knowledge about this must be made available globally, especially in low- and middle-income countries. This could help integrate and implement rehabilitation in health systems of countries worldwide and also help achieve the targets of Rehabilitation 2030, universal health coverage and Sustainable Development Goals.